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增生性永存瞳孔膜的转归

Outcome of hyperplastic persistent pupillary membrane.

作者信息

Lee Sang Mok, Yu Young Suk

机构信息

Department of Ophthalmology, College of Medicine, Seoul National University, Chongno-gu.

出版信息

J Pediatr Ophthalmol Strabismus. 2004 May-Jun;41(3):163-71. doi: 10.3928/0191-3913-20040501-09.

Abstract

PURPOSE

To evaluate the long-term visual outcome of eyes with hyperplastic persistent pupillary membrane.

PATIENTS AND METHODS

We adopted a retrospective approach involving 39 eyes of 24 Korean patients diagnosed as having hyperplastic persistent pupillary membrane, excluding patients who could not be observed beyond 3 years of age and eyes that had any other ocular anomalies that affect vision. Final best-corrected visual acuity and refractive status were compared according to treatment type and laterality. Mean visual acuity was transformed to the logarithm of the minimum angle of resolution (logMAR).

RESULTS

The mean final best-corrected visual acuity was 0.32 (standard deviation, +/- 0.41). Five eyes had a best-corrected visual acuity less than 20/70 at the last follow-up. Four eyes were unilateral (deprivation amblyopia) and one eye was bilateral (anisometropic amblyopia). There were no significant differences in final best-corrected visual acuity according to treatment type or laterality. Significant anisometropia was found in 11 of the 24 patients. The mean absolute value of anisometropia was greater in the surgical treatment group than in the medical treatment and observation groups (P = .048).

CONCLUSIONS

The visual prognoses for individuals with hyperplastic persistent pupillary membrane can be relatively good if the condition is appropriately managed. Unilaterality and poor initial visual acuity are indicators of a poor visual outcome. Surgery is effective when the opaque membrane retards visual maturation. Close follow-up with evaluation of visual acuity and refractive status is mandatory because this condition can lead to deprivation amblyopia and anisometropic amblyopia.

摘要

目的

评估增生性永存瞳孔膜患者眼睛的长期视力预后。

患者与方法

我们采用回顾性研究方法,纳入24例韩国患者的39只眼睛,这些患者被诊断为患有增生性永存瞳孔膜,排除3岁以后无法进行观察的患者以及存在任何其他影响视力的眼部异常的眼睛。根据治疗类型和患侧比较最终最佳矫正视力和屈光状态。平均视力转换为最小分辨角对数(logMAR)。

结果

最终最佳矫正视力的平均值为0.32(标准差,±0.41)。在最后一次随访时,5只眼睛的最佳矫正视力低于20/70。4只眼睛为单侧(剥夺性弱视),1只眼睛为双侧(屈光参差性弱视)。根据治疗类型或患侧,最终最佳矫正视力无显著差异。24例患者中有11例存在显著的屈光参差。手术治疗组的屈光参差绝对值平均值高于药物治疗组和观察组(P = 0.048)。

结论

如果增生性永存瞳孔膜得到适当处理,患者的视力预后可能相对较好。单侧性和初始视力差是视力预后不良的指标。当不透明膜阻碍视力成熟时,手术有效。由于这种情况可导致剥夺性弱视和屈光参差性弱视,因此必须密切随访并评估视力和屈光状态。

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